Intermittent neutrophil-monocyte bactericidal defects in a patient with sarcoidosis

Reccurrent abnormalities of polymorphonuclear leukocyte and monocyte bactericidal activity were demonstrated in a patient with sarcoidosis. Defective function occurred during hypercalcemia complicating recovery from Listeria meningitis, and during separate, unrelated episodes of erythema nodosum, staphylococcal cellulitis, and pneumococcal pneumonia. Leukocyte morphology, oxidative metabolism, degranulation, and content of myeloperoxidase and lysozyme were normal, but low leukocyte alkaline phosphatase activity was demonstrable on one occasion. Despite defective bactericidal function of monocytes, the patient's macrophages killed bacteria normally. The relationship between an intermittent leukocyte bactericidal defect and sarcoidosis is unclear; however, further studies of leukocyte function in sarcoidosis patients with opportunistic infection are indicated.